When and How Can I Ethically Hang Out With People As Lockdowns Ease?
The answer is still often no, but it’s getting more complicated.
Amid that financial uncertainty, the 29-year-old Austin, Texas, resident took state and federal social distancing guidance seriously—as a “a call to action to stay home,” as she put it. Since then, she’s been sheltering in place while trying to stay sane through family Zoom calls, online yoga classes, donating blood, and long walks.
So it should have come as a relief this week, when Texas Gov. Greg Abbott announced that restaurants, movie theaters, and malls may open at 25 percent capacity in most of the Lone Star State on Friday.
But Abbott’s announcement was greeted by consternation from public health experts, many of whom have expressed concern about the danger of prematurely relaxing restrictions.
For her part, Murrell isn’t ready to celebrate. In fact, she said, she’s resigned to a lot more isolation in the days to come.
“If it’s for the greater good, I can stay home,” said Murrell, who was let go from her marketing position at an event company on March 13 after most of its spring projects were cancelled or postponed. “But it’s difficult and it’s scary and a little intimidating to know that the people who are supposed to be well-versed on this don’t really know what to do.”
Public health experts have consistently said that socializing without enough tests, medical supplies, and contact-tracing could lead to resurgences of COVID-19. And state-specific models have shown that such outbreaks could cause thousands of deaths in places like Georgia and Florida, which are leading the pack to end lockdowns.
State leaders have pushed ahead anyway. But residents like Murrell are skeptical—even as she’s been weighed down by the lack of human contact.
“I just want to go outside,” said Murrell. “I don’t know when the next time I will be able to hug someone is, and that sucks. I don’t know even who I’m going to look to for that. I don’t know.”
Leaving the dispute between epidemiologists and—primarily Republican—governors anxious to open their economies aside, there isn’t a simple answer to Murrell’s questions. But some basic best practices on socializing amid the ease of lockdowns emerged in conversations with a slew of epidemiologists and infectious disease specialists surveyed for this story.
Among other things, folks should be aware of the nature of the outbreak in their area and—to the extent the testing situation allows—the health of those with whom they may be considering contact. And ultimately, experts agree that socializing at all is still a serious gamble, no matter what governors might be saying.
“In places where transmission seems to have been reduced, it’s probably not a bad idea to be in contact with people that you know, that you know have not been sick, even though there is the low possibility of asymptomatic infection,” said Dr. Arnold Monto, a professor of epidemiology and global health at the University of Michigan who has advised both the World Health Organization and the Defense Department on communicable diseases. “Everything is based on whether the person you’re encountering is infected, and, even more so, whether you’re in close contact with that individual.”
As of Thursday afternoon, according to state data, there were at least 27,054 coronavirus cases in Texas and 732 reported deaths. But in the state of about 29 million people, only 314,790 tests had been run, reported the Texas Tribune.
“It’s trial-and-error, and this is all a grand experiment because we’ve never done it before,” added Monto, noting that the rest of the country will, in all likelihood, benefit from the admittedly risky “experiment” states like Georgia and Texas and Florida are carrying out.
But there’s a big difference, he said, between having a drink in a friend’s backyard—masks on and six feet away—versus sitting at a restaurant with a packed table.
“It puts you in a situation where you will not be able to control the contact—you don’t know their history, or if they’ve been well,” said Monto. “If you increase the number of people, you increase the chances that someone is going to have the virus.”
Another Austinite, 27-year-old Natalie Hicks, admitted that she’s been juggling that kind of risk assessment over the past few months of social-distancing. Hicks was furloughed from her travel industry job for three weeks but has managed by cutting back nonessential expenses and trying to keep sane with her roommate—and through continuing to see her boyfriend, with whom she’s had living-room dance parties while missing live music.
“Technically, I’ve been breaking the rules because he’s not in my household,” Hicks acknowledged, of seeing her boyfriend. “But that’s where I draw the line.”
Hicks said she’s been wearing masks, limiting trips to the grocery store, participating in individual picnics six feet away from friends at the park, and occasionally grabbing takeout from a local Tex-Mex restaurant. “I’ve seen a lot of people kind of start to open up what they’re willing to do, and I want to make sure we’re doing it correctly. It’s hard to know where the line is, especially with politicians in Texas.”
While Murrell said she planned to remain at home for now, Hicks said she will probably try to visit her local restaurant once it reopens at 25 percent capacity, since it has a large outdoor patio and she wants to support its owners, whom she trusts will act responsibly and safely.
But local leaders like Mark Escott, Austin’s interim health authority, cautioned a city council meeting on Tuesday that the reopening of restaurants was coming “too soon,” since Austin was still working overtime to ramp up contact-tracing and testing to “protect vulnerable populations.” Without those measures, he said, authorities might not be able to recognize an outbreak in time to curb it. At that same city council meeting, an epidemiologist at the University of Texas at Austin showed policymakers a model that projected that lax regulations in Austin could create a summer outbreak forcing the city past its hospital capacity.
To be clear, Monto emphasized that, while moderate and responsible socializing in Austin or Atlanta might be possible, the same can’t be said for hot spots like New York. On Thursday, Gov. Andrew Cuomo announced an unprecedented plan to halt subway services overnight for deep cleaning and reinforced the need for social-distancing until the state can achieve a baseline of 30 contact-tracers for every 100,000 coronavirus cases. In the meantime, Cuomo added, the state will employ more than 1,000 full-time staffers dedicated to proactive social distancing enforcement and education.
Ultimately, socializing at all—anywhere—is still a grave risk, according to Dr. Brittany Kmush, an assistant professor at Syracuse University who specializes in epidemiology, global health, and infectious diseases.
“Purely from a disease-prevention perspective, it would definitely be safer to wait a week or two before lifting restrictions,” Kmush said, acknowledging that “there are consequences to staying isolated,” as well.
If you are in an area with a decrease in cases and feel you must socialize with a few family or friends for mental health reasons, Kmush explained, you “should still be very cautious.” It’s imperative to maintain as much distance as possible, wear masks, wash your hands frequently, and try not to touch your face.
And if you have symptoms or have been exposed to the virus, she added, “Don’t go out in public and risk it.”
“We still have a long way to go before the disease is under control,” Kmush continued, arguing that “there’s not really a safe way to go to a restaurant.”
On that score, Dr. Adrian Hyzler—the chief medical officer for Healix International, which provides medical information to organizations whose clients travel internationally—advised staking out businesses before going inside them in your state. The idea, he said, was to ensure they’re “taking the social distancing seriously and allowing proper separation of tables and diners.”
In locations where infections have decreased, in private spaces, he added, you can probably safely have a few friends over as long as you take the right precautions, maintain distance, and carefully disinfect surfaces and washrooms.
The benefit of socializing in private spaces, according to Kmush, is that if somebody becomes sick, it’s a lot easier to identify and notify anyone who may have been exposed.
But there are still a lot of unknowns associated with this deadly virus. Though U.S. health officials continue to stand by 14 days as the marker of the COVID-19 incubation period, there isn’t enough evidence to say how long somebody who is infected may be contagious.
So if you’re considering socializing with somebody who was sick, it’s safest to wait at least two weeks—and probably more—before close contact. And that doesn’t even include consideration for people who may have been infected but asymptomatic, which Kmush said may be as high as 40 percent of those with the virus. Likewise, the reliability of antibody tests—and how long, if at all, past infection confers immunity—are still in doubt.
The potential for socializing to go horribly wrong remains almost unspeakable. Clusters thought to be the result of so-called super-spreaders in cities like Chicago and Westport, CT, at events like funerals in Albany, Georgia, and cruise ships like the Diamond Princess are evidence of the need for vigilance, experts said.
“The virus hasn't gone away,” cautioned Hyzler, noting that “we only have one tool in our armory to protect ourselves and society—and that is to stop transmission.”